MEDICARE: DR. LESLIE MARIE BELT PH.D., LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1073652236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE MARIE BELT PH.D., LCSW

Provider Business Mailing Address
First Line	:	782 WEATHERLY DR
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-8941
Country	:	US
Telephone Number	:	931-645-3552
Fax Number	:

Provider Business Practice Location Address
First Line	:	782 WEATHERLY DR
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-8941
Country	:	US
Telephone Number	:	931-645-3552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	11/22/2023

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